The nutritional care and management of patients includes provision of adequate nutrition support to ensure that they attain and maintain a desirable body weight, improve nutritional status and avoid negative outcomes associated with over- or underfeeding. The success of nutrition support relies on accurately estimating energy requirements so that adequate energy and nutrients can be provided to the patient. Energy requirements are most accurately determined by measurement of energy expenditure. Most methods for doing so however are expensive, time-consuming, require trained technicians to perform them and are therefore impractical in the clinical setting. As such, prediction equations, which are easy to use, inexpensive and universally available, are commonly used to estimate the energy requirements of hospitalised patients. The accuracy of these equations however is questionable. Recently, a new portable hand-held indirect calorimeter (MedGem(tm), HealtheTech, USA), which has been promoted for its ease of use and relatively short measurement time, has been validated in healthy subjects but is yet to be validated in patients with illnesses. Weight loss and malnutrition occur commonly in patients with cancer and are often thought to be associated with disturbances in energy metabolism caused by the tumour. Minimising weight loss is an important goal for the nutritional care of patients with cancer. The ability to accurately determine the energy requirements of these patients is therefore essential for the provision of optimal nutrition support. This research project proceeded in two phases. Phase 1 aimed to determine current methods used by dietitians for estimating adult patients' energy requirements using a descriptive study. Results of this study informed phase 2, which aimed to investigate differences in energy expenditure of cancer patients compared to healthy control subjects and to compare different methods for determining energy requirements of people with cancer in the clinical setting. To address phase 1 a national cross-sectional survey of dietitians working in acute care adult hospitals was undertaken to determine their usual dietetic practice with respect to estimating patients' energy requirements. Responses to the survey (n=307, 66.2%) indicated a large variation in dietitians' practice for estimating energy requirements particularly with respect to the application of methods involving injury factors. When applied to a case study, these inconsistencies resulted in an extremely wide range for the calculated energy requirement, suggesting that there is error inherent in the use of prediction methods, which may be associated with negative consequences associated with under- or overfeeding. The types of patients for whom dietitians estimate energy requirements appears to be heavily influenced by feeding method. Initial dietetic education was identified as the main influencing factor in the choice of method for estimation of energy requirements. Phase 2 was addressed using four studies based on the same study population - a case-control study, two clinical validation studies and a measurement methods study. Patients had histologically proven solid tumours, excluding tumours of the breast, prostate and brain, and were undergoing anti-cancer therapy (n=18). Healthy control subjects were group matched to cancer patients by gender, age, height and weight from a purposive sample (n=17). Resting energy expenditure (REE) was measured by respiratory gas exchange using a traditional indirect calorimeter (VMax 229) and the MedGem indirect calorimeter. A measurement methods side-study established that steady state defined as a three-minute period compared to a five-minute period measured REE within clinically acceptable limits. REE was also predicted from a range of prediction equations. Analyses of available data found that REE in cancer patients was not significantly different from healthy subjects, with only a 10% higher REE observed in this sample of cancer patients when adjusted for fat free mass. For both cancer patients and healthy subjects the portable MedGem indirect calorimeter and all prediction equations did not measure or estimate individual REE within clinically acceptable limits compared to the VMax 229 (limits of agreement of approximately -40% to 30% for both the MedGem and prediction equations). Collectively, the results of this research project have indicated that current practical methods for determining patients' energy requirements in a clinical setting do not accurately predict the resting energy expenditure of individual subjects, healthy or with cancer. Greater emphasis should therefore be placed on ensuring intake meets requirements. For this to occur, dietetic practice should be focused on directly monitoring both patients' actual energy intake and patient outcomes, such as weight, body composition and nutritional status, to determine whether energy requirements are being met. This research has led to multiple recommendations for dietetic practice, focusing on the standardisation of education practices. Recommendations for future research address methodological improvements.

Consumer segmentation based on expenditure are usually done by using observedcharacteristics, such as age and income. This thesis highlights the problem with negativeexternalities which Venice suffers from, due to mass tourism. This thesis aims to assesswhether unobservable heterogeneity can be used to detect latent classes within tourismexpenditure. Segmenting the tourism market using this approach is valuable for policy making.Segmenting is also useful for the actors in the market to identify and attract high spenders. Inthat way, a destination may uphold a sustainable level of tourism instead of increasing touristnumbers. The method used for this approach is finite mixture modelling (FMM), which is notmuch used within consumer markets and therefore this thesis also contributes to tourismexpenditure methodology. This thesis adds to the literature by increasing the knowledge aboutthe importance of unobserved factors when segmenting visitors.The results show that four latent classes are found in tourism expenditure. Some of thevariables, which are significant in determining tourism expenditure, are shown to affectexpenditure differently in different classes while some are shown not to be significant. Theconclusions are that segmenting tourism expenditure, using unobserved heterogeneity, issignificant and that variables, which are barely significant in determining the expenditure ofthe population, can be strongly significant in determining the expenditure for a certain class.

Magister Administrationis - MAdmin / The effectiveness of foreign aid in bringing economic and social development is mired in controversy. However, despite the controversial debates on its effectiveness, poor countries of the world have been receiving and using aid as a leverage to relieve themselves from development constraints they faced. Ethiopia is no exception amongst developing countries. Since the time it joined the World Bank group in 1945, foreign capital inflow has remained an important source of revenue for the government. This paper examines the fiscal impact of aid inflow into Ethiopia using time series data for the period 1975-2005. The empirical findings reveal that inflow of foreign aid influences public decision on revenue and expenditure patterns. The result shows that a larger proportion of aid is allocated to capital expenditure and that only a small proportion goes to recurrent expenditure. There is a strong positive association between aid inflow and capital expenditure. The finding also shows that, while a very weak negative association exists between aid and taxation effort, aid and borrowing are used as alternative source of finance. / South Africa

This work aims to analyze current expenditures from the state budget in the years 2005 -- 2010 and the covering of public income. The first chapter deals with the public as a source of revenue for public expenditure. Following chapter explains the theoretical foundations of public spending. The first two chapters each contain a basic definition, a member of this type and structure of public finances. The third and final chapter is devoted to the practical part of my work. Here is carried out detailed analysis of revenue and expenditure of the Czech Republic state budget. I focused mainly on the generic division and then to the more comprehensive examination of current expenditure. Analysis of public revenue and expenditure is made based on macroeconomic indicators Czech Republic, then in itself dependent on public revenues and public spending trend analysis and individual annual changes. The conclusion stated evaluation and analysis are also formulated proposals and recommendations arising from it.

This thesis serves to investigate the varying effects of public health-care expenditure and private health-care expenditure on economic growth in developed and developing countries. I have contributed to the literature by using an expansive geographical dataset, lagged variables to address endogeneity, and model averaging techniques. I do so by first addressing the issue of model uncertainty, which is inherent in growth studies, by using Bayesian Model Averaging as the method of analysis in the thesis. Examination of 126 countries (32 developed and 94 developing) in the period 2000-2018 reveals that there is no variation in the impact of public health expenditure on economic growth between developed and developing countries. Contrary to public health expenditure, private health expenditure has a varying impact on both developed and developing countries. My analysis also reveals that the results hold when lagged variables are used in the model. Public health expenditure has unanimously a negative effect on economic growth in both developed and developing countries. Private health expenditure, on the other hand, has a positive impact on economic growth in developed and developing countries. Furthermore, I found that the results are robust to different model specifications. JEL Classification I15, O11,...

In order to provide enough economic growth so that the majority of individuals within the jurisdiction are satisfied with government services, state governments typically pursue two budgetary choices for economic growth: overall increased production and stabilization (Bivens, 2014). According to two budgetary choices as a path to economic growth, this research investigates the relationship between capital expenditure or savings and economic growth. It covers the years 1990 through 2013 and uses a paneled data set at the state level in the United States. The first model for this study is the structural equation model (SEM), which examines the direct and indirect effects of capital expenditure and state government savings on economic growth by including the volatility of the total expenditure as a mediating factor. Then, this dissertation investigates the relationships among capital expenditures, the total expenditure volatility and savings by using the endogenous growth or the OLS regression model. This dissertation can conclude that both of the two budgetary choices for state governments are effective for economic growth. Under controlling state characteristics, they are positively related to economic growth, which supports the allocation role of government for economic growth. However, this study finds that state governments do not find any supportive evidence on the fact that they can attain the stabilization role of government for economic growth. Even though they spend money on savings or capital expenditure from Keynesian macroeconomic theory, it does not lead to budgetary stabilization of the total expenditure. Thus, this dissertation leaves the missing links of the relationship between both fiscal policies and volatility inconclusive while it supports that volatility can negatively affect economic growth.

The benefits of an active lifestyle are undisputed, yet our understanding of the contribution of physical activity (PA) to the daily energy budget is limited. The prevailing model of a linear relationship between PA and total energy expenditure (TEE) has been challenged by models that predict an upper limit of TEE (constrained) or a compensatory decrease elsewhere in the budget in response to increased PA (compensated). The purpose of this study was to determine the equation of best fit between PA and TEE using linear and non-linear modeling in the light of existing models. Secondarily, we sought to explore relationships between PA and postulated means of behavioral (time sedentary) and physiologic (i.e. Immune, reproductive) compensation. We measured TEE in 57 healthy weight stable adults (18 to 58 yrs., F = 28) who ranged from being sedentary to ultra-endurance trained runners (0 to 78 mi/wk.) using the doubly labeled water technique and PA and sedentary time using a waist mounted triaxial accelerometer during the same 14-day period. We obtained fasting serum (albumin, cortisol, TNFα, C-reactive protein, free testosterone, TSH and T3), plasma (leptin) and whole blood (WBC with differential) concentrations. Using linear and non-linear modeling, we observed a positive linear relationship between PA (Vector Magnitude Counts per Minute ) and TEE (R2=0.313, Y = 1.427*X + 1930 and adjusted for fat free mass (FFM) R2=0.363, Y = 1.151*X + 2155). We identified no association between PA and RMR ( R2=0.015 and adjusted for FFM R2=0.010). In addition, we observed an association between higher PA and lower % time sedentary (R2=0.723). Although inconsistent, there was a general trend for higher PA but not TEE or its components to be associated with lower immune and reproductive biomarkers. These findings support a conventional linear model though intervention studies will be needed to further address this issue. / Doctor of Philosophy / The health benefits of being physically active are well known. At the same time there is much that is not understood about the relationship between physical activity and how much energy we spend in a day (total energy expenditure). It has been assumed for a long time that the amount of energy we spend is a simple matter of adding the calories burned at rest, digesting food, and exercising and as we exercise more we continue to add an equal number of calories to the daily budget. We call this the linear or additive model – energy spent increases in a straight line as physical activity increases. Because we have techniques for measuring total energy expenditure in people going about their usual lives that were not widely available until recently due to cost, scientists have developed new ideas about how increases in physical activity affect total energy expenditure. The constrained model suggests that there is a cap on how many calories we can burn in a day and that our bodies will save energy in other parts of the budget if our physical activity remains high enough to reach or exceed that cap. The second idea is called the compensated model like the constrained model predicts that the rate we spend energy slows down as we exercise more because the body has saved energy in other parts of the budget (compensation). Researchers don't know for sure if either of these models are correct, so we conducted a study to determine how physical activity and total energy expenditure are related and if our findings agree with either of these models. We were also interested in determining how physical activity is related to energy spent at rest (resting metabolic rate ) and energy spent being active (physical activity energy expenditure). Finally, we wanted to determine ways that the body might compensate. One way is to spend more time sedentary. Another way is to save energy on less urgent needs like the immune and reproductive systems. Our main goal was to create an equation that explain how higher levels of physical activity are related to total energy expenditure and other parts of the energy budget (RMR and physical activity energy expenditure). We also created equations that explain how physical activity is related to sedentary behavior and immune and reproductive markers in the blood. We recruited 57 male and female volunteers that represent a wide range of physical activity levels – from sedentary to ultra-endurance trained runners who routinely run as much as 80 miles per week. We measured the energy they spent and physical activity over 2 weeks. In our sample, we found that physical activity was related to total energy expenditure and physical activity energy expenditure in a linear way. We did not find a cap on the amount of energy spent (constraint). We found that participants who exercised more spent less time sedentary not more meaning that we did not find behavioral compensation. It is possible that there was compensation from the immune system because some of the markers of immune function were lower in people who were more physically active, but it was not consistent in all of the blood markers. A larger study using an exercise intervention is needed to assign causation to the correlation we found.

4 pp. / Recently, a number of global positioning system (GPS) devices have been introduced commercially which exploit GPS, transforming frequent measurements of time and location, into an estimate of energy expenditure. This fact sheet reviews how GPS watches (GPS fitness units) measure energy expenditure of individual during physical activity. We list popular GPS watches that are on the market and showed pros and cons of these watches. After our field testing, we decided that Garmin Forenunner 305 is our best pick for the GPS watch. We included information on Geocashing, which is one of popular outdoor activities using GPS receiver or other navigational techniques.

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The affairs of public financial management in the local government operates within two legal frameworks, one adopted by national government and one adopted by legislatures at local level (Mikesell, 2007:36). A legislative framework for public financial management includes a vast number of legislation and public policies that have a direction bearing on the way in which financial management is dealt with in the different spheres of government. The financial affairs in the local government are guided by various legislative frameworks which regulate financial management in the three spheres of government. The Municipal Finance Management Act (MFMA) Act 56 of 2003 in addition provides guidelines for securing sound and sustainable financial management. The need to achieve sound public financial management and assurance of acceptable and transparent levels of financial risk has become paramount. To realize the developmental mandate, the Integrated Development Plan (IDP) and budgeting are seen as the most significant tool towards effective public financial management. Government activities require funds to undertake the planned activities and such funds require special care to safeguard the public funds. This study aimed to assess the budgetary control practices in the Ngwathe Local Municipality. The objectives were realized by means of literature review, questionnaires and participant observations. The results of the interviews with the participants (community) revealed that the public is somehow not interested in local government affairs. It was indicated that they are mostly concerned about the social affairs and the job opportunities. The interviews with the municipality revealed that the budgetary control mechanisms are effective. Budget management is a requirement that covers budget preparation, budget implementation, and budget control. The Municipality established the budget office which serves as a mediator between the municipal council and the departmental managers. A good budget is characterized by participation, comprehensiveness, standards, flexibility, feedback and analyses of cost and revenues. However, the municipality should enhance the culture of community participation in local governance. / MA (Public Management and Governance), North-West University, Vaal Triangle Campus, 2014